Which of the following is an absolute contraindication to using BMP-2?

• A. Young age
• B. 76-year-old male with lung cancer
• C. Patients with diabetes
• D. Patients with a history of smoking

Answer: (B)

Using Bone Morphogenetic Protein-2 (BMP-2) has specific contraindications, predominantly based on safety profiles related to underlying health conditions. In particular, the presence of malignancies, such as lung cancer, significantly raises concerns regarding BMP-2 use. This is primarily due to the potential for stimulated tissue growth to interfere with cancer management, especially if the patient is undergoing treatments that could be compromised by increased local cell proliferation or osteoinductive activity.

Patients with active cancer may face risks of exacerbating their condition, leading to complications or unintended effects like local recurrence or metastasis. As a result, BMP-2 is contraindicated in this patient population.

In contrast, while young age, diabetes, and a history of smoking can influence treatment decisions and may require careful consideration, they do not present the same immediate risk as the presence of an active malignancy. Young age and diabetes, for instance, are managed with different approaches and can sometimes involve BMP-2 under controlled conditions. Smoking history can also impact healing and recovery but does not strictly contraindicate the use of BMP-2 in the same definitive manner as an active cancer diagnosis.